Special RF Response to Government, Pushing Back

December 9, 2019

Dear Members:

The special meeting of the Representative Forum took place on Saturday, December 7 in Calgary. Delegates received a full update on the current negotiations with government for a new financial agreement. There was a presentation on the evolving AMA response to the 11 consultation proposal items that government has released and that were the subject of my November 29 President’s Letter. The RF also endorsed the Board of Directors’ proposed plan to respond to these challenges and ensure that government hears our concerns.

Standing together for negotiations

The RF passed a number of motions. These support the unity of the profession behind the AMA and convey a strong message to government that their current approach is inappropriate. The consultation is an end-run around negotiations for many of the proposals that legitimately belong at the negotiating table and must remain there.

Here are a few of the motions:

That the Representative Forum stand behind the AMA as their representative for the current negotiations, which includes expectation of respectful treatment by government, in good faith and with due process, including dispute resolution.

That items that will be specified by the AMA in our response to government’s Insured Services Consultation are part and parcel of current negotiations and must be addressed in that venue.

The consultation proposals

The RF received the AMA analysis of the 11 consultation items, reflecting the latest feedback from sections and individual members. For primary care and particularly rural medicine, the potential impact continues to be devastating. As I mentioned in my November 29 President’s Letter, we are still seeking clarity to understand the impact of some of the items on acute care, but impact there will be. We will be working to measure that this week.

To date we’ve had solid input through the sections. The RF provided additional insight on several items. We’ve also heard from nearly 1,000 individual members (and counting) with their thoughts and concerns. Our health economics team is continuously compiling this content. There are also evening meetings scheduled with Alberta Health this week to work through outstanding questions. As I write this, an updated version of the draft response to government is being prepared. It will be posted to the Alberta Health Insured Services Consultation page on our website.

As I listened to delegates speaking to the assembly this weekend, I was moved by the anxiety for what these proposals would mean to members’ ability to maintain practices and serve patient communities for whom they have invested their careers. This was particularly apparent with our rural family medicine colleagues who face the heaviest blow from what government has tabled. On that front, Section of Rural Medicine President Dr. Ed Aasman and I have released a joint statement.

In the faces of the RF, I saw the determination to speak up, to push back and to do so together, united as a profession. I will be seeking an emergency meeting with the minister to convey the profession’s messages, supported by some of our physician leaders.

We will of course continue discussions at the negotiating table. This week we will also work to complete our formal response on the consultation proposals, due December 20. Thank you to the sections who have responded swiftly and to the members who have provided individual comments. Further input can be provided on our website until Monday, December 16.

What you can do

You may be wondering what you can do to help. You will hear from me on that front very soon: we have a plan for action, from today through December 23, and December 27 to the new year and beyond. Please watch for details very soon.

Your comments are welcome in the following ways:

• Communicate with me privately and directly by email if you would like a reply: president@albertadoctors.org. 
• Comment publicly below on this President’s Letter on the AMA website (please be aware that comments are public, i.e., not members-only, even if you are logged in as a member):

In your service,

Christine P. Molnar, MD, FRCPC
President, Alberta Medical Association